BackgroundBehavioural and psychological symptoms of dementia (BPSD) are non-cognitive symptoms commonly associated to Alzheimer's disease (AD). The characterization of the clinical profile of AD patients might help to better understand disease evolution and to improve diagnosis and treatment. Thus, the aim of the present study is to describe the clinical profile of AD patients, and to correlate the presence of BPSD with the severity of the disease.MethodsA cross-sectional, observational and multicenter study was conducted at 115 centres in Spain. Patients suffering from AD with higher and lower BPSD scores (ADAS-Noncog score 26-50 and ≤25, respectively) were included. Demographic and clinical data were collected, and dementia severity was assessed by the Mini Mental State Examination (MMSE) [mild 27-21, moderate 20-11, severe ≤10]. The use of ADAS-Noncog in clinical practice was also explored.ResultsA total of 1014 patients (463 with higher and 551 with lower BPSD scores) were included (mean age 77 ± 7 years, 65% women). Almost all patients (90%) had BPSD at inclusion, 17% of which reported psychotic outbreaks. The most prevalent symptoms were lack of concentration (56%), tremors (56%), depression (44%), lack of cooperation (36%), and delusions (32%). Patients with higher BPSD scores showed a significantly higher prevalence of psychotic symptoms (delusions, hallucinations, and delirium) and tremors, while emotional symptoms (tearfulness and apathy) predominated in patients with lower BPSD scores. MMSE and ADAS-Noncog scores were negatively associated (p = 0.0284), suggesting a correlation between cognitive impairment and BPSD. Lack of concentration and appetite change significantly correlated with MMSE (p = 0.0472 and p = 0.0346, respectively). Rivastigmine and donepezil were the first choice therapies in mild to moderate dementia. ADAS-Noncog was generally considered better or similar to other scales (82%), and 68% of the investigators were willing to use it in the future.ConclusionsOur study shows that patients with AD have a high prevalence of noncognitive symptoms, and that cognitive impairment and BPSD are correlated. Therefore, ADAS-Noncog is a useful evaluation tool.

This study confirms the good psychometric properties of the Zarit scale found in previous studies. The dependence component appeared to be most influenced by the application of a PIP in the clinical trial. Caregivers with a Zarit scale score of 60 or more benefit most from the PIP.

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OBJECTIVES: Huntington's disease (HD) is a rare neurodegenerative disease leading to sustained disability for patients, and poor quality of life (QoL) for patients and their caregivers. This study, conducted in Spain as a part of an international survey, investigated the QoL of family carers of patients with HD. METHODS: The hospital 'Hospital Ramon y Cajal' provided their patients with two self-reported questionnaires (one for patient and one for his/her caregiver). Caregivers were asked to answer sociodemographic questions and complete the short version of the HD Quality of Life Battery for Carers (HDQoL-C), a previously validated questionnaire by Aubeeluck A. and Buchanan H. The determinants of caregiver QoL relating to patients' clinical characteristics (motor, functional, behavioural disorders) were studied by regression analysis, adjusting for age, sex and occupational categories. The relationship between QoL of patients and caregivers was also explored using Pearson's correlations. RESULTS: Sixty caregivers and 59 patients were included. The mean (Ϯ standard deviation; SD) age of caregivers was 49 (Ϯ14) years and 73% were female. 10% were completely unsatisfied with their overall QoL and 12% were totally satisfied. Patients' motor score and functional score were found to be drivers of the Spanish caregivers' QoL (pϭ0.02, for both) but the behavioral score was not (pϭ0.18). The caregiver total QoL score was not significantly correlated with patients EQ-5D index score (pϭ0.11) and HD-specific QOL assessment, H-QOL-I (pϭ0.36). CONCLUSIONS: Caregiver's QoL worsens as patient motors' symptoms and functional capacity deteriorate. Patient and caregiver QoL was not directly correlated. A limitation of this study is the low sample size; HD is a rare disease, which made it difficult to recruit large sample.